# NORTHERN ILLINOIS UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Speech and Hearing clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982756417
- **Authorized official:** LORETTA JULIANN SCHAIRER SLP (SPEECH LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (815) 753-6528

## Contact information

- **Practice address:** 1 LUCINDA AVENUE, NORTHERN ILLINOIS UNIVERSITY, DEKALB, IL 60115
- **Practice address phone:** (815) 753-1481
- **Practice address fax:** (815) 753-1664
- **Mailing address:** 1 LUCINDA AVENUE, NORTHERN ILLINOIS UNIVERSITY, DEKALB, IL 60115
- **Mailing address phone:** (815) 753-1481
- **Mailing address fax:** (815) 753-1664

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | IL | Yes |

## Other

- **Enumeration date:** 01/17/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 397581129001 | — | IL |